Top-Up Feeds

[HollyNF122]

Hi there!

I have recently been advised to try top-up feeds with my LO. The only problem is that I don't know much about top-up feeds or how to use them correctly without getting my LO addicted to snacking. Any advise?

Holly

[newkidontheblock]

Hi:) How old is your LO? Any particular reason for giving a top up? And do you mean offering to nurse a second time or giving a bottle of expressed milk or formula?

[HollyNF122]

Hello!

My LO is almost 4 months. We are trying to transition to a 4-hour EASY routine and was advised to maybe try some top up feeds prior to nap time to help him last longer between feeds and to help with naps. I was thinking of offering a bottle of expressed breast milk for the top up. Also, I'm not sure how much I should offer?

Thanks!

Holly

[newkidontheblock]

Ah, okay. Are you having a problem with short naps? When shifting from a 3 to 4 hour EASY, they can be some OT if it isn't done gradually and that could lead to short naps also. You can move towards a 3.5 A instead and then slowly on to 4. Most babies can go 4 hours without needing another feed before naps. If you still feel that hunger is leading to short naps, you can nurse half an hour or so before the nap or even half an hour after the first nursing session as more of the fatty hindmilk would be available. If you are breastfeeding, then just offer the breast as usual. But first observe whether your LO actually needs it otherwise you could inadvertently encourage snacking

[HollyNF122]

Yes, we are having trouble with short naps. Our LO will sleep for 30 or 45 mins before waking up. We have started by going 3.5 hrs between feeds and I thought we would do that for a few days before trying 4 hrs. I'm not sure that I'm producing enough milk though for his growing appetite... He seems satisfied when I nurse him but he will take 6 or 7 oz at a time from a bottle but when I pump I'm lucky to get 4oz! I'm trying really hard to not have to supplement with formula but I'm afraid I'm headed down that road.

[newkidontheblock]

Oh hun, that's a common misconception. Your baby gets loads more milk than the pump does. They are so much more efficient at getting it out, yk? 30 - 45 minute naps are common at this age and sounds like more of a routine issue than anything to do with your supply. In fact, one sure fire way to lower your supply is to unnecessarily supplement with formula. Why don't you post your routine on the sleep forum and we could have a look at it and help you out:)

[MasynSpencerElliotte]

A baby generally will take more from a bottle because it is easy not necessarily because they need that much. A yield really is not a good indication of what baby is getting when they bf as they are so so efficient. That said, none of my kids truly made a 4 hourly feedroutine until they were introduced to solids around 5.5/6 months which sort of acted as the top up! I did top ups close to nap time, but not so close that they would fall asleep nursing.

[*Ali*]

We don't recommend the yield test anymore as subsequent research has since shown pumping to be a very unreliable indicator of yield. If you pump 4oz then your baby, who is much more efficient than a pump, is probably getting at least 5oz but could very well be getting 6 or 7oz. Plus it takes longer for a baby drinking a bottle to get the "I'm full" message as the milk is so easily obtained from the bottle and they've probably drunk another couple ounces before realising they are full. So the fact he takes 7oz from a bottle doesn't necessarily mean he needs 7ozs at each feed. The average intake of a BF baby is 25oz (although anything from 19-30oz is considered normal) so a baby on 5 feeds a day would only take an average of 5oz a feed and a baby on 6 feeds would only need to take 4oz or so at each feed.

The only way your supply will catch up with his growing demands is to nurse him more often. When babies ask to feed more it is to send the message to your body to make more milk. It isn't an indication that you cannot produce what he needs. Many EBF babies don't make it to 4hrly feeds by 4mo and often it takes until 6mo when they start solids. Again that isn't an indication of mama's supply, it is just the nature of easily digested breast milk.

I would do as PP suggests and offer a top up straight from the breast half an hour after the first feed. That is when milk is really fatty and will help keep him full.

Posted with Heidi...

[HollyNF122]

I posted on the night wakings board a few days ago because of our LO's frequent (every 45-60mins) night wakings. Our schedule is on there. We have had him on the easy routine pretty much since day one. That is why I fell so lost. Someone recommended that we go to a 4-hour schedule since my LO is almost 4-months old. We have done a 3.5 hour routine the past two days and it hasn't caused any problems. Although, it hasn't helped our night waking issue. It's encouraging to hear that my LO is probably getting enough to eat. I just worry about my milk supply because our stockpile in the freezer is dangerously low.

[*Ali*]

Do you need a frozen stock pile so you can be away from your LO? If not then I would not worry about having a frozen stash. As long as you can feed directly from the breast there will be milk being made.

[HollyNF122]

Yes, I do need a frozen stockpile. I work 3 days a week and like to have a little bit frozen for that purpose.

[*Ali*]

Ah ok, then maybe we need to look at when you are pumping. What is your current pumping schedule? Are you using a pump or hand expressing? Is there a time when you get more milk out than any other time?

[HollyNF122]

In the days that I work I pump 5 times a day. Usually at 4:30, 9, 1, 4:30, and 9. I work in a hospital so we have really good pumps. When I'm at home I will just pump after I nurse. For example, I will nurse on the right side then pump on the right side after to increase my supply. Then ther next feeding time I will do the left side. I will continue this all day and then pump both sides right before going to bed. Do you think I should nurse on one side and pump the other at each feeding time? I have been trying to avoid that for situations when I'm out and about and cannot pump while nursing and I don't want to get engorged in one side.

[newkidontheblock]

Have you tried pumping first thing in the morning - half an hour or so before you need to feed? I get a lot then. And yes, just before going to bed at night.

[*Ali*]

Do you offer second side to your LO at each feed?  That will help to increase supply. Then you could pump what is left in the second side and probably get away with skipping the pumping if not convenient.  Or perhaps just hand express for comfort if you need.

You're obviously pumping frequently so that should really help.